Periodic Reporting for period 2 - SCUBY (SCale Up an integrated care package for diaBetes and hYpertension for vulnerable people in Cambodia, Slovenia and Belgium)
Période du rapport: 2020-07-01 au 2021-12-31
The SCUBY project is divided in three phases: a formative, intervention and evaluation phase. In the formative phase (year 1), the objective is to assess the current implementation in each country of the integrated care package (ICP) - consisting of primary care-based diagnosis, treatment, education and self-management support and collaboration, along with its facilitators and barriers and cost (WP2-4). In the implementation phase (year 2-3) the objectives entails the development and implementation of an improved scale-up strategy through a roadmap including activities related to stakeholder engagement and the definition of proximal and distant outcomes for implementation monitoring (WP5). Finally, the objective of the evaluation phase (year 4) will be to determine the impact and scale-up evaluation. For the impact, a Cascade of Care approach (CoC) to assess the number of patients with HT and/or T2D, those linked to care, treated and successfully managed clinical outcomes. For the scale-up evaluation, scale-up progress of the ICP will be tracked along the three axes of the scale-up framework. Aside from these types of evaluation, a process evaluation will be conducted in years 2 and 3, to monitor implementation (WP4-6). As the cornerstone of the SCUBY project is to provide a platform to share lessons learnt, throughout the three phases of the project, the objective of dissemination work package (WP7) will be to disseminate knowledge of scaling-up of the integrated care package at regional and global levels to countries with similar specificities
During this time period, a minimal Cascade of Care consisting of indicators for a minimal dataset to allow for comparison across countries was developed. This was achieved by seeking a common ground among the country-specific guidelines and available data for the operationalization of the different steps of the Cascade of Care. A qualitative study was undertaken to assess the relevance and feasibility of monitoring of the indicators. In addition, an extended Cascade of Care was developed to enable the evaluation of the integrated care package within countries between the different care models. In conjunction with the development of these two cascades of care, a data management plan was elaborated with all partners to extract anonymised data.
Based upon this broad contextual understanding derived from qualitative data on the implementation, barriers and facilitators of integrated care, as well as insights into stakeholders’ positions and power in the country-specific challenges and policies, we have initiated the planning of activities to develop a roadmap to scale up integrated care in each implementation country. Thus, all three countries have launched formal and informal policy dialogues with stakeholders to improve and/or facilitate scale-up. Alongside these endeavours, an evaluation protocol is being developed for the process, implementation and impact of scale up, which will contain three dimensions of scale up: (a) the population coverage of the integrated care package (b) the expansion of the intervention package towards the integrated care package, and (c) the integration of the intervention into the larger health system.
With a view to facilitating an exchange of experiences, the project’s objectives, progress, methods, tools and results are being disseminated and communicated through the established mechanisms to link stakeholders among countries. Along with the development of dissemination materials, publications, and training programs for SCUBY researchers, a Community of practice (https://www.thecollectivity.org/en/communities/22) and a SCUBY website (https://www.scuby.eu) were created to display blog posts and all updates on scientific progress, published results or milestones reached are displayed.
To oversee the project, a steering Committee (SC) was created to ensure that all strategic decisions in the consortium are made in a transparent fashion. In addition, to the six meetings held with the SC, two major face-to-face consortium meetings were held: the Kick off in Ljubljana, Slovenia (M2) in collaboration with hosting partners, where the methodology of the first year was elaborated and a second consortium meeting in Siem Reap – Cambodia (M14).